Liliana Mereu

Liliana Mereu
Santa Chiara Hospital · Ob&Gyn

MD PhD

About

87
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Publications

Publications (87)
Article
Background Management of recurrent urinary tract infection (rUTI) is still challenging. A better understanding of the natural history of rUTI could help us reduce antibiotic use and improve antibiotic stewardship. Objective To describe the effect of risk identification, stratification, and counseling on the natural course of the disease in women w...
Article
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Objective: Coronavirus disease 2019 (COVID-19) outbreak has correlated with the disruption of screening activities and diagnostic assessments. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of CO...
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Introduction: Elderly endometrial cancer (EEC) patients represent a challenging clinical situation because of the increasing number of clinical morbidities. In this setting of patients, minimally invasive surgery (MIS) has been shown to improve surgical and clinical outcomes. The aim of this study was to evaluate the peri-operative and oncological...
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Background The aim of this retrospective comparative study was to assess the impact of COVID-19 and delayed emergency department access on emergency surgery outcomes, by comparing the main clinical outcomes in the period March–May 2019 (group 1) with the same period during the national COVID-19 lockdown in Italy (March–May 2020, group 2). Methods...
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The European Society of Gynaecological Oncology (ESGO), the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG), the International Ovarian Tumour Analysis (IOTA) group and the European Society for Gynaecological Endoscopy (ESGE) jointly developed clinically relevant and evidence-based statements on the preoperative diagnosis of...
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The European Society of Gynaecological Oncology (ESGO), the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG), the International Ovarian Tumour Analysis (IOTA) group, and the European Society for Gynaecological Endoscopy (ESGE) jointly developed clinically relevant and evidence-based statements on the pre-operative diagnosis...
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Purpose We aimed to assess the impact of low-volume metastasis (micrometastasis and isolated tumor cells) on disease-free survival (DFS) of women with early-stage cervical cancer. Methods Women with clinically suspected stage 1A-IB2 (FIGO 2018 classification) disease who underwent retroperitoneal nodal staging between October 2010 and April 2018,...
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Laparoendoscopic single site surgery (LESS) refers to a spectrum of surgical techniques that allow the performance of laparoscopic surgery through consolidation of all ports into one surgical incision. LESS has emerged as a potentially less invasive alternative to multiport laparoscopy and in the last year in gynecology; hence, this approach has be...
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The European Society of Gynaecological Oncology (ESGO), the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG), the International Ovarian Tumour Analysis group (IOTA) and the European Society for Gynaecological Endoscopy (ESGE) jointly developed clinically relevant and evidence‐based consensus statements on the pre‐operative d...
Preprint
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BACKGROUND: The aim of this retrospective comparative study was to assess the impact of the COVID-19 related disease on emergency surgery, comparing clinical main outcomes in the period March –May 2019 (Group 1) with the same period in Covid-19 Italian lockdown (March-May 2020, Group 2). METHODS: A comparison (Group 1 versus 2) was performed betwee...
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Response to: Correspondence on "ESGO/ISUOG/IOTA/ ESGE Consensus Statement on pre-operative diagnosis of ovarian tumors" by Thomassin-Nagarra et al We thank Isabelle Thomassin-Nagarra et al for their interest in the ESGO/ISUOG/ IOTA/ESGE consensus statement on the pre-operative diagnosis of ovarian tumors. This statement is based on a careful review...
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Endometriosis is one of the most common medical conditions affecting the women. The study aimed to evaluate the safety and efficacy of robotic-assisted laparoscopic surgery (RAS) versus conventional laparoscopic surgery (LPS) in the treatment of endometriosis. PubMed, Embase, Cochrane and CINAHL databases were searched from January 1995 to March 20...
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Objective In the last two decades, many reports demonstrated the unreliability of endometrial biopsy pathology showing an AH (atypical hyperplasia) to exclude a synchronous EEC (endometrioid endometrial carcinoma), with an underestimation of EEC in up to 50% of women. Hysteroscopy is now considered the standard diagnostic tool for endometrial patho...
Article
Objective Ultrasound features of granulosa cell tumors of the ovary are still poorly defined. The aim of this study is to widen current knowledge on the role of sonographic gray scale and pattern recognition in the characterization of these tumors and to compare the ultrasound characteristics of primary diagnosis and recurrences. Methods Transvagi...
Preprint
Full-text available
Objective: In the last two decades many reports demonstrated the unreliability of endometrial biopsy pathology showing an AH (Atypical Hyperplasia) to exclude a synchronous EEC (Endometrioid Endometrial Carcinoma), with an underestimation of EEC in up to 50% of women. Hysteroscopy is now considered the standard diagnostic tool for endometrial patho...
Article
Introduction: The aims were to evaluate quality of life, cosmetic results and surgical outcomes of robotic single-site and robotic multiport total laparoscopic hysterectomy with sentinel lymph node mapping in women treated for low- risk endometrial cancer. Material and methods: The study is a prospective, multicenter, case-control study conducte...
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Atrial thrombosis is a rare complication of Venous Thrombo-Embolism (VTE) and is associated with a higher mortality rate. In presence of a patent foramen ovale, a thrombus can be trapped in (thrombus straddling in foramen ovale: TSFO), constituting a high-risk condition named Impending Paradoxical Embolism (IPDE). No previous case of IPDE in pr...
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Background: Cytomegalovirus infections (CMV) may have severe outcomes during pregnancy, but to date there are no evidence of efficacy for a systematic screening during pregnancy. A systematic serological screening of CVM infections in pregnancy has been active for some time in the Province of Trento, Northern Italy (540,000 inhabitants).
Article
Background: The aim of this study is to compare robotic single-site hysterectomy (RSSH) and robotic multiport hysterectomy (RMPH) for endometrial cancer (EC) in obese patients in terms of surgical outcomes. Methods: This retrospective study compares RSSH with RMPH in obese patients with EC and FIGO stage I-II divided in 3 classes according to th...
Conference Paper
Introduction/Background The majority of women who undergo radical hysterectomy for endometrial cancer (EC) are obese and they may benefit from robotic surgery. The aim of this study is to compare robotic single-site hysterectomies (RSSH) and robotic multiport hysterectomies (RMPH) for EC in obese patients. Methodology This study compares RSSH with...
Conference Paper
Introduction/Background Granulosa cell tumor (GCT) is the most common sex cord stromal tumor and constitute less than 5% of all ovarian cancers. Pre operative diagnosis is challenging. Sonographic findings are multiple, the mass could present with different patterns. Methodology A retrospective study of histopathologically confirmed ovarian granul...
Conference Paper
Introduction/Background RSS surgery is an option for EC treatment and its feasibility for lymph node assessment and SLN mapping has been describe.We analyzed RSS and RM approaches to treat low risk EC. Methodology Prospective multicenter cohort study, setting in Santa Chiara Hospital of Trento and University Hospital of Pavia and Novara. Between J...
Article
Objective: The present study analyzed long-term outcomes and complications of laparoscopic lateral suspension (LLS) with mesh to treat apical and anterior pelvic organ prolapse (POP). Study design: A prospective cohort study on 125 patients with vaginal bulge and apical +/- anterior prolapse scheduled for LLS who consecutively underwent LLS betw...
Article
Aim: To evaluate the efficacy of a medical device containing xyloglucan, hibiscus and propolis in the management of recurrent urinary tract infections (rUTIs). Patients & methods: Sixty-one women affected by rUTIs received this medical device, one capsule a day for 15 days (one cycle every month, for 6 months), in an observational, prospective stud...
Article
Background: and Purpose: In endometrial cancer, staging is performed surgically. Controversy about the required extent of lymph node removal is ongoing. In low-risk endometrial cancer (FIGO Stage 1, endometrioid histology, Grades 1 and 2), the risk of lymph-node involvement is 4-17%. Since the introduction of near-infrared optics and the use of in...
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Objective To analyze surgical outcomes of total laparoscopic hysterectomy (TLH) for benign disease. Methods Retrospective analysis of 361 consecutive cases, prospectively collected from January 2012 to June 2016, of women who underwent TLH in St. Chiara Hospital in Trento, Italy. Clinical, demographic, surgical, and intra and perioperative data we...
Article
Objective: The aim of this study was to evaluate the surgical and oncological outcome of robotic surgical staging with hysterectomy (RH) plus or less pelvic and aortic lymphadenectomy, compared to the same procedures performed by laparoscopic surgery (LH) in obese patients (BMI≥30 kg/m2) with endometrial cancer. Material and methods: From Octobe...
Article
OBJECTIVES to quantify and identify the proportion of miscarriages in the province of Trento (Trentino-Alto Adige Region, Northern Italy) in 2010-2016, managed exclusively at the emergency room (ER). DESIGN population surveillance study. SETTING AND PARTICIPANTS comparison between the Trentino computerized database of registration to the ER for m...
Article
Background: The aim of the present study is to analyze the feasibility, safety and learning curve of Mini- Laparoscopic Lateral suspension (LLS) for the treatment of apical and anterior defects following pelvic organ prolapse. Methods: This is a cohort study on a retrospective series of 35 consecutive patients who underwent Mini-LLS for symptoma...
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Background In the last few decades, the introduction of technologies such as single-site surgery, robotics, and sentinel lymph node detection has reduced invasiveness in the treatment and staging of endometrial cancer patients. The goal of the present prospective cohort study is to evaluate the feasibility of lymph node fluorescence detection with...
Article
Study objective: To estimate the incidence of infection after diagnostic and operative hysteroscopic procedures performed in an in-office setting with different distension media (saline solution or carbon dioxide). Design: Prospective, multicenter, observational study (Canadian Task Force classification II-2). Setting: Tertiary women's health...
Article
Objectives To evaluate the importance of leukocyturia in detecting the transition from asymptomatic bacteriuria to symptomatic infection in women with recurrent urinary tract infections. Methods In this cross‐sectional study, we evaluated all women with recurrent urinary tract infection and asymptomatic bacteriuria who had been enrolled in two pre...
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Objective: The aim of this study was to determine the impact of the sentinel lymph node mapping algorithm (SLN-A) on the staging in high-risk endometrial cancer (EC) compared to SLN plus selective lymphadenectomy (S-LND). Methods: We retrospectively analyzed the database from a multicenter collaboration that included women with high risk feature...
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Purpose To critically appraise published randomized controlled trials (RCTs) comparing laparo-endoscopic single site (LESS) and multi-port laparoscopic (MPL) in gynecologic operative surgery; the aim was to assess feasibility, safety, and potential benefits of LESS in comparison to MPL. Methods A systematic review and meta-analysis of eleven RCTs....
Article
Objective: To evaluate the feasibility and the safety of robotic single site hysterectomy (RSSH) plus or less pelvic lymphadenectomy in FIGO stage I-II endometrial cancer. Materials and methods: We prospectively collected patient demographics, operative times, complications, pathologic results, and length of stay on all patients who underwent RS...
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Background: Women suffering from recurrent urinary tract infections (rUTIs) are routinely treated for asymptomatic bacteriuria (AB), but the consequences of this procedure on antibiotic resistance are not fully known. The aim of this study was to evaluate the impact of AB treatment on antibiotic resistance among women with rUTIs. Methods: The st...
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Bilateral salpingo-oophorectomy (BSO) in carriers of BRCA1 and BRCA2 mutations is widely recommended as part of a risk-reduction strategy for ovarian or breast cancer due to an underlying genetic predisposition. BSO is also performed as a therapeutic intervention for patients with hormone-positive premenopausal breast cancer. BSO may be performed v...
Article
The objective was to evaluate the perioperative outcomes, safety, and patient acceptance of single-port access laparoscopic subtotal hysterectomy (SPAL-SH) in comparison with conventional multiport access laparoscopic subtotal hysterectomy (MPA-SH). Case-control study. Classification: Canadian Task Force Classification II-2 SETTING: The study was c...
Article
Background: Minimally invasive surgery has a central role in managing benign and malignant conditions in gynecology patients. While laparoscopy decreases morbidity directly related to the surgical approach, each working port used carries an inherent risk of bleeding, infection, concomitant iatrogenic visceral injury, hernia formation, and a less-sa...
Article
Background To evaluate the feasibility, safety and peri- and postoperative outcomes of robotic single-site hysterectomy for gynaecological diseases.Methods We studied 45 patients who underwent robotic single-site hysterectomy for benign and malignant disease at two institutions during May 2012–June 2013. We evaluated whether any correlation exists...
Article
Objective: To examine the feasibility of performing pelvic lymphadenectomy with robotic single site approach. Recent papers described the feasibility of robotic-single site hysterectomy [1-3] for benign and malign pathologies but only with the development of new single site 5mm instruments as the bipolar forceps, robotic single site platform can b...
Article
Objectives To develop and externally validate a novel nomogram predicting recurrence risk probability at 12 months in women after an episode of urinary tract infection.Methods The study included 768 women from Santa Maria Annunziata Hospital, Florence, Italy, affected by urinary tract infections from January 2005 to December 2009. Another 373 women...
Article
Even if some evidence exists of a positive correlation between regular intake of phytoestrogens, polyphenols, antioxidants and women's sexual health, there is not a study addressing the potential correlation between daily apple consumption and women's sexual function. We aim to assess whether there is a tie between daily apple intake and sexual fun...
Article
To prospectively evaluate the accuracy of laparoscopy performed in satellite centres (SCs) to describe intra-abdominal diffusion of advanced ovarian cancer (AOC). Patients with a clinical/radiological suspicion of AOC were included in the protocol. SCs were selected among those surgeons spending a short intensive training period at the Coordinator...
Article
Minimal-invasive, single-port laparoscopic surgery is a recent innovation that may improve surgical outcomes. In this chapter, we review published research on single-port surgery in gynaecology, and the different surgical instruments available. Challenges, advantages, indications and potential future rules of this new approach are also discussed. S...
Article
Background: Laparoscopy requires a set of skills such as intracorporeal stitching and knotting. The aim of this study is to present an effective specialized training course for the laparoscopic suturing technique. Materials and methods: We designed a specialized 5-day training course for laparoscopic suturing skills with theoretical and practica...
Article
OBJECTIVE: The authors present extra peritoneal para-aortic lymphadenectomy performed by single port laparoscopy in case of bulky lymph nodes. METHOD: A 56 years old woman, affected by squamous carcinoma of the cervix, FIGO stage 1B2, with bulky common iliac and para-aortic lymph nodes at TC scan, was scheduled to extra peritoneal para-aortic lymph...
Article
Objective We present the technique to perform single access robotic laparoscopy for endometrial cancer treatment. Methods Four patients with histological diagnosis of endometrial adenocarcinoma G1 and instrumental FIGO stage IA or IB underwent total single access robotic laparoscopic extra-fascial hysterectomy and bilateral salpingo-oophorectomy. T...
Article
Abstract Objective: To evaluate whether the new bipolar resectoscope (BR) 22 Fr (Karl Storz) represents a reliable improvement in operative hysteroscopy and to compare the new device to the 26 Fr BR (Karl Storz). Material and methods: A prospective observational study. From June 2010 through May 2011, 158 consecutive patients treated with bipolar r...
Article
To evaluate clinical outcomes associated with the resection of both endometrioma and posterior broad ligament (PBL) among women with PBL adhesion associated with endometrioma. Between January 2007 and December 2009 at the Villanova Hospital, Florence, Italy, a prospective trial was conducted on 99 consecutive patients with unilateral or bilateral e...
Article
Introduction Chemotherapy agents such as cyclophosphamide (Cy) and Doxorubicin (D) are commonly used in the treatment of cancer in young females. Cy is an alkylating agent and D is a topoisomerase inhibitor. Hence they show cyotoxic activity through entirely different mechanisms. We have previously shown that these agents result in apoptotic death...
Article
To estimate the efficacy and tolerability of low dose spinal anesthesia during operative hysteroscopy in a group of patients with high surgical risks. Case series study (Canadian Task Force Classification II-2). Tertiary centers for women health care. A total of 47 women affected by endometrial polyps (n = 32), myomas (n = 8), and abnormal uterine...
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Single-port access laparoscopy (SPAL) technique is developing in the gynecological field but few experiences on SPAL myomectomy have been reported. A case of an infertile nulliparous woman who has been observed to have an intramural–subserosal myoma of 4cm and bilateral sactosalpinx is reported. The patient underwent a SPAL to remove the myoma and...
Article
In this study, we investigated the prognostic value of metastasis tumor antigen 1 expression in 81 untreated patients with ovarian cancer. The expression of metastasis tumor antigen 1 was evaluated by immunohistochemistry, and staining was analyzed in relation to clinicopathologic variables, disease-free survival, and overall survival. High express...
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The fundamental idea is to have all of the laparoscopic working ports entering the abdominal wall through the same incision. Single-incision laparoscopic surgery is an alternative to conventional multiport laparoscopy. Single-access laparoscopy using a transumbilical port affords maximum cosmetic benefits because the surgical incision is hidden in...
Article
Vaginal hysterectomy may at times prove difficult and require laparoscopic assistance to ensure safety of operations. This article reports a case in which single port laparoscopic assistance enabled vaginal hysterectomy in a patient with severe uterine ventrofixation. The use of an innovative device and tips to be applied are described.
Article
Puropose To evaluate the feasibility of single port access laparoscopy (SPAL) for the treatment of ovarian endometrioma. Case Report Three patients affected by single ovarian endometrioma underwent cyst excision using a laparoendoscopic single port approach with a new multiport, reusable trocar, and flexible, curved and standard laparoscopic instr...
Article
To present our initial experience using single access laparoscopic surgery for the treatment of benign adnexal pathologies. Sixteen patients with benign adnexal pathologies underwent salpingoophorectomy (n=9), ovarian cyst enucleation (n=5), or salpingectomy (n=2) using a laparoendoscopic single site approach with a new multiport reusable trocar an...
Article
Bowel resection for endometriosis improves pain symptoms and quality of life in symptomatic women. However, little is known about fertility after surgery, particularly after such treatment in women suffering from infertility. The aim of the present study was to evaluate post-operative fertility and long-term clinical outcome after laparoscopic colo...
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We investigated the effects of laparoscopic excision of endometriosis with unilateral parametrectomy on bladder, rectal, and sexual function as well as patient satisfaction. Women who underwent this procedure between February 1, 2006 and November 15, 2007 were enrolled. Patient characteristics, pre- and postoperative findings, and follow-up data we...
Article
Background: Elderly patients with ovarian carcinoma have a poorer prognosis compared with their younger counterpart, and this depends in most cases on undertreatment. The aim of this study was to evaluate, retrospectively, the pattern of care and the prognosis of elderly patients with platinum-sensitive recurrent ovarian cancer. The SOCRATES study...
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The purpose of the study was to determine the influence of bowel endometriosis on fertility, and to study whether its removal improves fecundity in women with endometriosis-associated infertility. Three groups of infertile patients were included in the study. Group A (60 women) consisted of patients who underwent surgery for endometriosis with colo...
Article
To evaluate the short- and long-term outcomes of laparoscopic colorectal resection for endometriosis. This study included 357 consecutive patients who underwent colorectal resection. We evaluated intraoperative and postoperative complications, symptom outcomes, and long-term follow-up. Three hundred forty-three patients (96.1%) underwent laparoscop...
Article
The prevalence of venous thromboembolism (VTE) in ovarian cancer during first-line chemotherapy (CHT) ranges between 6.4% and 10.6%. Identification of the susceptible population is crucial for effective thromboprophylaxis. We performed a retrospective study of all our patients with epithelial ovarian cancer who underwent ambulatory first-line CHT b...
Article
To evaluate prospectively the efficacy of laparoscopic ureterolysis versus ureteroureterostomy in women with ureteral endometriosis. Prospective study. Department of Obstetrics and Gynecology, Ospedale Sacro Cuore of Negrar, Verona, Italy, a tertiary care endometriosis referral center. Endometriotic patients with moderate-severe ureter dilatation....
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Study Objective: A strong association exists between adenomyosis and endometriosis and a common pathogenetic mechanism was proposed. The aim of this study was to evaluate whether and how the presence of concurrent adenomyosis can affect the outcome of laparoscopic excision of deep endometriosis.